6 ms·

Hospitals should post prices of their procedures in the lobby. A surgeon gets $500 to repair a hernia and the hospital pulls in $5k for the ancillary services.

by bawana 9y ago

Hospitals should post prices of their procedures in the lobby. A surgeon gets $500 to repair a hernia and the hospital pulls in $5k for the ancillary services. The surgeon has to see the patient,make the diagnosis, provide the treatment, provide the aftercare and be the 'face'. The hospital-insurance complex has managed to create this fantasy world with complicated rules and somehow have sequestered themselves from the free market. They set their own prices and by virtue of being of local monopolies thwart the ability of the individual to choose. Hospitals have become like cable companies.

geomark 9y ago
Where I live that is the case. Prices are not only made available, they are often advertised on websites and even on TV. Just one example of how it is done here https://www.bumrungrad.com/en/womens-center-obgyn-thailand/packages/delivery https://www.bumrungrad.com/en/womens-center-obgyn-thailand/p...
savanaly 9y ago
It's not like hospitals are wildly profitable to run though? I think the inflated costs are due to the little understood phenomenon of "cost disease" rather than owners of hospitals extracting outrageous rent for themselves as I think you are implying.
- adventured 9y ago
  You're correct about the spread of cost disease, it has essentially reached every corner of US healthcare. The part that hospitals are particularly guilty of, is unnecessary admin expense inflation. The US education system has seen an almost identical problem. Building buildings that aren't needed, hiring 10x the admin staff that the system had 30 or 40 years ago, etc. It's the system rewarding itself, bureaucrats hiring more bureaucrats, playing lords as they go on building sprees that aren't needed. There are very few readily available levers in the US healthcare system, that can be used to properly pull back against such cost spirals and spending behavior.
  - gregw134 9y ago
    Last time I was out the hospital they had robots running around to just to pick up towels. Robots are great and all, but that's a symptom of not managing costs.
    - bawana 9y ago
      thank you all for your input. The hospital you linked in Asia. It seems that SE Asia has leapfrogged us in the concept of capitalism and the free market. Indeed, it is a 'free-for-all' in terms of lack of regulation, but certainly it is not 'free care for all'. Here in the US, The medical-industrial complex has seen how other industrial complexes deal with our government and are trying to mimic that gravy train. I still remember articles about the $500 hammer, and $2000 toilet the Navy had purchased in the thousands. We need to get back to our roots. A free market where people can buy what they want when they want it. Health care insurance is an oxymoron. Everyone gets sick. There is no probability of someone NOT using the system. The minute you try to amortize the costs over time or large populations to provide services, there is infinite demand. Insurance would make sense for events that are RARE. House fires, automobile accidents, gun accidents, etc. (BTW, why isnt gun insurance mandatory? That way everyone could be happy- you could still buy a gun as long as you paid your $5000 premium. The insurance companies could make more money, there would more 'gun control', and the money could go to the emergency rooms that take care of shooting victims. But OH NO! Hospitals would figure out a way to spend that money too and it would never be enough!! Maybe the gun insurance premiums could be given to the victims !) Anyway, there is no easy fix until we start to force our politicians to GET OFF THEIR ASSES. It particularly annoys me that they offer 'thoughts and prayers' after each mass murder and do nothing else. They should be in Florida digging the graves. Representing their constituents properly.
dominotw 9y ago
> Hospitals should post prices of their procedures in the lobby. A surgeon gets $500 to repair a hernia and the hospital pulls in $5k for the ancillary services Cost for repairing hernia is not exactly the same for every patient though. Depends on the severity, general health of the patient and a million other things. Not sure if its even possible to put an upfront price. Even if they did, how do patients know beforehand what exactly they need to figure how much they are going to pay. Maybe that works for simple things like a flu shot but seems impossible to for anything even slightly more involved.
- PeterisP 9y ago
  The same reasons would apply elsewhere, they're not USA-specific, so they don't explain why it's not possible to do the same thing that's successfully done elsewhere. Sure, there's some inherent variance always - the same thing happens in many industries and doesn't prevent them from offering fixed quotes; the service provider is the one best qualified to estimate the expected variance in their costs and offer appropriate pricing. Sure, there may be special requirements that justify charging extra for a particular case; that's not an obstacle from telling the customer about that beforehand. Well, not in ER, but most care is not ER.
  - dominotw 9y ago
    > The same reasons would apply elsewhere, they're not USA-specific, so they don't explain why it's not possible to do the same thing that's successfully done elsewhere. I 've never seen a chart with prices for hernia in the lobby , anywhere that I've lived( I am not from USA). Where has it been successfully done?
    - PeterisP 9y ago
      Well, it's not literally placed in the lobby (since the price chart is big and different locations/types/severities of e.g. hernia mean different types of operations, and the choice of which type of operation should be chosen is generally not made by you but by the consulting doctor) but it's conceptually the same in that the price list is publicly available and you know beforehand about what exactly you're going to be charged. E.g. a link to a random local (to me) hospital's pricelist (not in English, sorry) https://www.aslimnica.lv/lv/content/neirokirurgijas-operacijas https://www.aslimnica.lv/lv/content/neirokirurgijas-operacij... starts with two different procedures for herniated spinal disc repair. That's it, if your doctor recommends to do this operation, then if it's not covered by your insurance this is what you'll pay for the procedure followed by a standard per-day inpatient fee for however you're required to stay during recovery. It's up to the hospital how to split the amount among all the involved specialists labor, equipment, drugs and supplies required. As far as I've seen when traveling, the same (i.e. once it's clear what you want to be done, there's a price known beforehand) applies in most European and Asian countries, but it's hard to provide online examples as you must look for the local non-english (the english-speaking market, USA+UK+UK dominions, seems quite different from the rest of the world) services since English websites tend to be oriented for "medical tourism" services which is different from how the locals handle their healthcare, and there's a significant language barrier. How does pricing of elective surgeries work in your area?

by bawana 9y ago

geomark 9y ago

Where I live that is the case. Prices are not only made available, they are often advertised on websites and even on TV. Just one example of how it is done here https://www.bumrungrad.com/en/womens-center-obgyn-thailand/packages/delivery https://www.bumrungrad.com/en/womens-center-obgyn-thailand/p...

savanaly 9y ago

It's not like hospitals are wildly profitable to run though? I think the inflated costs are due to the little understood phenomenon of "cost disease" rather than owners of hospitals extracting outrageous rent for themselves as I think you are implying.

adventured 9y ago
You're correct about the spread of cost disease, it has essentially reached every corner of US healthcare. The part that hospitals are particularly guilty of, is unnecessary admin expense inflation. The US education system has seen an almost identical problem. Building buildings that aren't needed, hiring 10x the admin staff that the system had 30 or 40 years ago, etc. It's the system rewarding itself, bureaucrats hiring more bureaucrats, playing lords as they go on building sprees that aren't needed. There are very few readily available levers in the US healthcare system, that can be used to properly pull back against such cost spirals and spending behavior.
- gregw134 9y ago
  Last time I was out the hospital they had robots running around to just to pick up towels. Robots are great and all, but that's a symptom of not managing costs.
  - bawana 9y ago
    thank you all for your input. The hospital you linked in Asia. It seems that SE Asia has leapfrogged us in the concept of capitalism and the free market. Indeed, it is a 'free-for-all' in terms of lack of regulation, but certainly it is not 'free care for all'. Here in the US, The medical-industrial complex has seen how other industrial complexes deal with our government and are trying to mimic that gravy train. I still remember articles about the $500 hammer, and $2000 toilet the Navy had purchased in the thousands. We need to get back to our roots. A free market where people can buy what they want when they want it. Health care insurance is an oxymoron. Everyone gets sick. There is no probability of someone NOT using the system. The minute you try to amortize the costs over time or large populations to provide services, there is infinite demand. Insurance would make sense for events that are RARE. House fires, automobile accidents, gun accidents, etc. (BTW, why isnt gun insurance mandatory? That way everyone could be happy- you could still buy a gun as long as you paid your $5000 premium. The insurance companies could make more money, there would more 'gun control', and the money could go to the emergency rooms that take care of shooting victims. But OH NO! Hospitals would figure out a way to spend that money too and it would never be enough!! Maybe the gun insurance premiums could be given to the victims !) Anyway, there is no easy fix until we start to force our politicians to GET OFF THEIR ASSES. It particularly annoys me that they offer 'thoughts and prayers' after each mass murder and do nothing else. They should be in Florida digging the graves. Representing their constituents properly.

dominotw 9y ago

> Hospitals should post prices of their procedures in the lobby. A surgeon gets $500 to repair a hernia and the hospital pulls in $5k for the ancillary services Cost for repairing hernia is not exactly the same for every patient though. Depends on the severity, general health of the patient and a million other things. Not sure if its even possible to put an upfront price. Even if they did, how do patients know beforehand what exactly they need to figure how much they are going to pay. Maybe that works for simple things like a flu shot but seems impossible to for anything even slightly more involved.

PeterisP 9y ago
The same reasons would apply elsewhere, they're not USA-specific, so they don't explain why it's not possible to do the same thing that's successfully done elsewhere. Sure, there's some inherent variance always - the same thing happens in many industries and doesn't prevent them from offering fixed quotes; the service provider is the one best qualified to estimate the expected variance in their costs and offer appropriate pricing. Sure, there may be special requirements that justify charging extra for a particular case; that's not an obstacle from telling the customer about that beforehand. Well, not in ER, but most care is not ER.
- dominotw 9y ago
  > The same reasons would apply elsewhere, they're not USA-specific, so they don't explain why it's not possible to do the same thing that's successfully done elsewhere. I 've never seen a chart with prices for hernia in the lobby , anywhere that I've lived( I am not from USA). Where has it been successfully done?
  - PeterisP 9y ago
    Well, it's not literally placed in the lobby (since the price chart is big and different locations/types/severities of e.g. hernia mean different types of operations, and the choice of which type of operation should be chosen is generally not made by you but by the consulting doctor) but it's conceptually the same in that the price list is publicly available and you know beforehand about what exactly you're going to be charged. E.g. a link to a random local (to me) hospital's pricelist (not in English, sorry) https://www.aslimnica.lv/lv/content/neirokirurgijas-operacijas https://www.aslimnica.lv/lv/content/neirokirurgijas-operacij... starts with two different procedures for herniated spinal disc repair. That's it, if your doctor recommends to do this operation, then if it's not covered by your insurance this is what you'll pay for the procedure followed by a standard per-day inpatient fee for however you're required to stay during recovery. It's up to the hospital how to split the amount among all the involved specialists labor, equipment, drugs and supplies required. As far as I've seen when traveling, the same (i.e. once it's clear what you want to be done, there's a price known beforehand) applies in most European and Asian countries, but it's hard to provide online examples as you must look for the local non-english (the english-speaking market, USA+UK+UK dominions, seems quite different from the rest of the world) services since English websites tend to be oriented for "medical tourism" services which is different from how the locals handle their healthcare, and there's a significant language barrier. How does pricing of elective surgeries work in your area?